中国青少年脊柱侧凸筛查临床实践指南及路径指引

Adolescent scoliosis screening in China:clinical practice guideline and pathway

青少年脊柱侧凸是发生在青少年人群中的常见脊柱疾病。青少年脊柱侧凸患者早期无明显症状,当出现脊柱畸形时往往需要手术治疗。通过早期筛查及时发现脊柱侧凸,能够有效避免疾病的进展。对青少年脊柱侧凸筛查工作进行规范非常必要。指南的制定过程参考世界卫生组织推荐的指南制定方法,由多学科专家组成指南制订小组,通过多轮针对临床医生的在线问卷调研确定指南中需要定义的重要临床问题。对青少年脊柱侧凸领域已发布的相关指南、系统评价以及临床随机对照研究进行文献综述,并对相关证据进行评价。经过多轮德尔菲投票确定指南的推荐意见及其推荐强度。最终形成10条推荐意见,涉及青少年脊柱侧凸的筛查对象、青少年脊柱侧凸的筛查方法及筛查后的临床路径指引,旨在为我国青少年脊柱侧凸筛查的实践提供指导和帮助。

Adolescent scoliosis(AS)is a prevalent disorder of spine in adolescents.AS patients have no obvious clinical manifestations in the early stage.However,surgery is often required when with spinal deformities.Early screening and detection of scoliosis could effectively prevent the progression of the AS.Therefore,evidence based recommendations for the screening of AS was developed.The development process of this present guideline was conducted according to the WHO guideline handbook.A Guideline Working Group was established firstly.The clinical questions and importance of these questions were framed according to several rounds of online surveys intended to get the clinical questions concerned from doctors.Systematic reviews of existing guidelines,reviews and high-quality randomized control trials about AS screening published recently were undertaken to evaluate evidence quality.The consensus recommendations regarding AS screening and strength of recommendations were produced following several rounds of Delphi voting.Finally,a total of 10 recommendations,including the screening population,the screening methods and the clinical pathways after screening were developed.The present clinical practice guideline could provide guidance and help for clinicians in screening of AS in China.